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Family History

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3.5

As noted above (see section 2.2.5 Participations), the HL7 "subject" participant overlaps in meaning with the SNOMED CT Subject Relationship Context.


Where a family member has a condition, regardless of whether the observation code contains an explicit Subject Relationship Context, the subject of the observation is the family member, and not the patient. Where the observation code does include an explicit Subject Relationship Context, the subject participant can also be used where needed to provide further information about the subject.


3.5.1
<observation classCode="OBS" moodCode="EVN">
  <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
  <text>Family history of cancer in father</text>
  <value xsi:type="CD" code="275937001|Family history of cancer|:408732007|Subject relationship context|=9947008|Biological father|" codeSystem="2.16.840.1.113883.6.96"/>
</observation>

This observation uses an explicit SNOMED CT Subject relationship context attribute to represent the fact that the subject of the observation is the father.


3.5.2
<observation classCode="OBS" moodCode="EVN">
  <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
  <text>Family history of cancer in father</text>
  <value xsi:type="CD" code="363346000|Cancer|" codeSystem="2.16.840.1.113883.6.96">
    <displayName value="Cancer"/>
  </value>
  <subject typeCode="SBJ">
    <relatedEntity classCode="PRS">
      <code code="9947008|Biological father|" codeSystem="2.16.840.1.113883.6.96">
        <displayName="Biological father"/>
      </code>
    </relatedEntity>
  </subject>
</observation>	

This example is equivalent to the preceding example, using the subject participant rather than the SNOMED CT Subject relationship context attribute to represent the fact that the subject of the observation is the father.